Provider Demographics
NPI:1760710065
Name:BROOKS, ALLISON D (ACNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:D
Last Name:BROOKS
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10465 SPARROW CT
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-2781
Mailing Address - Country:US
Mailing Address - Phone:503-536-3827
Mailing Address - Fax:
Practice Address - Street 1:10465 SPARROW CT
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-2781
Practice Address - Country:US
Practice Address - Phone:503-536-3827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201050037NP363LA2100X
CA455670163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19378OtherCALIFORNIA NPF
OR201050037NPOtherNURSE PRACTITIONER LICENSE